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Vermersch S, Arnaud A, Orbach D, Andre N, Berger C, Kepenekian V, Brigand C, Fresneau B, Poli-Merol ML, Habougit C, Varlet F, Scalabre A. Multicystic and diffuse malignant peritoneal mesothelioma in children. Pediatr Blood Cancer 2020; 67:e28286. [PMID: 32277799 DOI: 10.1002/pbc.28286] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 02/20/2020] [Accepted: 03/02/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Malignant and multicystic peritoneal mesotheliomas are extremely rare tumors in children, developing from mesothelial cells. No specific guidelines are available at this age. METHODS We performed a retrospective analysis of all identified children (< 18-year-old) treated in France from 1987 to 2017 for a diffuse malignant peritoneal mesothelioma (DMPM) or a multicystic peritoneal mesothelioma (MCPM). RESULTS Fourteen patients (5 males and nine females), aged 2.2 to 17.5 years, were included. The most frequent presenting symptoms were abdominal pain, ascitis, and alteration in the general condition. Eight patients had epithelioid mesothelioma, three had biphasic mesothelioma, and three had MCPM. Eight patients with DMPM diagnosis received cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC). Among them, six patients had neoadjuvant systemic chemotherapy, one patient, post-operative chemotherapy, and one patient CRS and HIPEC only. Three patients received only systemic chemotherapy. All patients with MCPM had only surgery. After a median follow-up of seven years (2-15), six patients (6/11; one death) with DMPM and two patients (two/three) with MCPM had a local and distant recurrences. CONCLUSION Peritoneal mesothelioma in children is a rare condition with difficult diagnosis and high risk of recurrence. Worldwide interdisciplinary collaboration and networking are mandatory to help diagnosis and provide harmonious treatment guidelines.
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Affiliation(s)
- Sophie Vermersch
- Department of Pediatric Surgery, University Hospital of Saint-Etienne, Saint-Priest-en-Jarez, France
| | - Alexis Arnaud
- Department of Pediatric Surgery, University Hospital of Rennes, Rennes, France
| | - Daniel Orbach
- SIREDO Oncology Center, Institut Curie, PSL University, Paris, France
| | - Nicolas Andre
- Department of Pediatric Hematology and Oncology, La Timone Children's Hospital, Marseille, France
| | - Claire Berger
- Department of Pediatric Oncology, University Hospital of Saint-Etienne, Saint-Priest-en-Jarez, France
| | - Vahan Kepenekian
- Department of Adult Surgical Oncology, University Hospital of Lyon, Lyon, France
| | - Cécile Brigand
- Department of Digestive Surgery, Strasbourg University, Strasbourg, France
| | - Brice Fresneau
- Department of Children and Adolescents Oncology, Institut Gustave Roussy, Paris, France
| | | | - Cyril Habougit
- Department of Pathology, University Hospital of Saint-Etienne, Saint-Priest-en-Jarez, France
| | - François Varlet
- Department of Pediatric Surgery, University Hospital of Saint-Etienne, Saint-Priest-en-Jarez, France
| | - Aurélien Scalabre
- Department of Pediatric Surgery, University Hospital of Saint-Etienne, Saint-Priest-en-Jarez, France
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Varlet F, Raia-Barjat T, Bustangi N, Vermersch S, Scalabre A. Treatment of Gynecomastia by Endoscopic Subcutaneous Mastectomy in Adolescents. J Laparoendosc Adv Surg Tech A 2019; 29:1073-1076. [DOI: 10.1089/lap.2019.0256] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- François Varlet
- Department of Pediatric Surgery, University Hospital, Saint-Etienne, France
| | | | - Nasser Bustangi
- Department of Pediatric Surgery, University Hospital, Saint-Etienne, France
| | - Sophie Vermersch
- Department of Pediatric Surgery, University Hospital, Saint-Etienne, France
| | - Aurelien Scalabre
- Department of Pediatric Surgery, University Hospital, Saint-Etienne, France
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Scalabre A, Maniouloux F, Vermersch S, Patoir A, Haddad E, Lopez M, Varlet F, Tiffet O. Utility of radiation-free imaging for initial evaluation of pectus excavatum. Interact Cardiovasc Thorac Surg 2019; 29:503-509. [DOI: 10.1093/icvts/ivz145] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 05/03/2019] [Accepted: 05/05/2019] [Indexed: 11/13/2022] Open
Abstract
Abstract
OBJECTIVES
The OrtenBodyOne scanner is a radiation-free, 3-dimensional imaging system recently developed for evaluation of the severity of pectus excavatum (PE). The goal of this study was to evaluate the utility of this new imaging system compared with that of computed tomography (CT) for the evaluation of the severity of PE.
METHODS
Patients treated for PE from April 2015 to January 2017 with available CT and OrtenBodyOne data were included. Correlations between indexes calculated from CT and from OrtenBodyOne were determined by applying the non-parametric Spearman correlation procedure with a Bonferroni correction to adjust for multiple comparisons.
RESULTS
Forty men (90.9%) and 4 women (9.1%), 20 with symmetrical (45.5%) and 24 with asymmetrical PE (54.5%), were included. The median age was 16.1 years (range 4.3–63.5 years). The following measures and indexes acquired using OrtenBodyOne and CT were significantly correlated: pectus depth (r = 0.84; P = 0.002), anthropometric index (r = 0.81; P = 0.002) and asymmetry index (r = 0.67; P = 0.002). The correlation between the CT Haller index and the external Haller index was only significant for symmetrical PE (r = 0.57; P = 0.008).
CONCLUSIONS
The OrtenBodyOne imaging system can be used to evaluate the severity of symmetrical PE using the external Haller index. Asymmetry and anthropometric indexes are more reliable for the evaluation of asymmetrical PE. Measures can be repeated throughout treatment while avoiding unnecessary irradiation.
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Affiliation(s)
- Aurélien Scalabre
- Chest Wall Deformities Unit, University Hospital of Saint-Etienne, CHU de Saint-Etienne Hôpital Nord, Saint Etienne Cedex 2, France
| | - Floriane Maniouloux
- Chest Wall Deformities Unit, University Hospital of Saint-Etienne, CHU de Saint-Etienne Hôpital Nord, Saint Etienne Cedex 2, France
| | - Sophie Vermersch
- Chest Wall Deformities Unit, University Hospital of Saint-Etienne, CHU de Saint-Etienne Hôpital Nord, Saint Etienne Cedex 2, France
| | - Arnaud Patoir
- Chest Wall Deformities Unit, University Hospital of Saint-Etienne, CHU de Saint-Etienne Hôpital Nord, Saint Etienne Cedex 2, France
| | - Elie Haddad
- Chest Wall Deformities Unit, University Hospital of Saint-Etienne, CHU de Saint-Etienne Hôpital Nord, Saint Etienne Cedex 2, France
| | - Manuel Lopez
- Chest Wall Deformities Unit, University Hospital of Saint-Etienne, CHU de Saint-Etienne Hôpital Nord, Saint Etienne Cedex 2, France
| | - François Varlet
- Chest Wall Deformities Unit, University Hospital of Saint-Etienne, CHU de Saint-Etienne Hôpital Nord, Saint Etienne Cedex 2, France
| | - Olivier Tiffet
- Chest Wall Deformities Unit, University Hospital of Saint-Etienne, CHU de Saint-Etienne Hôpital Nord, Saint Etienne Cedex 2, France
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Zamfir Snykers C, De Plaen E, Vermersch S, Lopez M, Khelif K, Luyckx S, Philippe P, Varlet F, Steyaert H. Is Laparoscopic Pyeloplasty for Ureteropelvic Junction Obstruction in Infants Under 1 Year of Age a Good Option? Front Pediatr 2019; 7:352. [PMID: 31608264 PMCID: PMC6773808 DOI: 10.3389/fped.2019.00352] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 08/07/2019] [Indexed: 12/26/2022] Open
Abstract
Purpose: Laparoscopic pyeloplasty in children younger than 1 year of age is still debatable due to its supposed technical difficulties and failure rate. We present our experience and outcome in infants. Materials and Methods: A retrospective study was conducted in 3 Departments of Pediatric Surgery. We reviewed the records of the children under 1 year of age operated on for ureteropelvic junction obstruction (UPJO), between 2007 and 2017. Anderson-Hynes laparoscopic transabdominal dismembered pyeloplasty was performed. Patients' demographics, results of preoperative and postoperative exams, perioperative details, complications, hospital stay, and long-term follow-up results were analyzed. Results: Sixty cases were operated on during this period (49 boys, 11 girls). Mean age at operation was 4.5 months (1-12 months). Mean operating time was 140 min (80-240 min). There was no conversion in this group. There were four early complications: 1 ileus, 1 hypertension immediately post-operatively requiring medical treatment, 1 omental herniation through a drain orifice, and 1 percutaneous transanastomotic stent migrated intra-abdominally. The two last children had to be reoperated. Mean hospital stay was of 2 days (1-10 days). Late complications: two patients (3.4%) presented a recurrence of UPJO, one had been re-operated 15 months later and for the patient with persistent hypertension, nephropexy was performed for malrotated kidney, 1 year after pyeloplasty. Long term follow-up with a mean of 2.8 years (1-10 years) showed that surgery improved mean pelvic dilatation from 31.8 mm (13-63 mm) preoperatively to 15.3 mm (4-40 mm) postoperatively (P < 0.0001). The renal function slightly improved, from a mean of 35.7% (5-55%) it passed to 40.5% (0-54%), p = 0.137. In three cases the operated kidney became finally non-functional and atrophic. Conclusions: Laparoscopic transperitoneal pyeloplasty is feasible and safe in children younger than 1 year of age. Nevertheless, it requires experience and good intra-abdominal suturing skills. Laparoscopic pyeloplasty has a success rate comparable with open treatment but with less morbidity and better cosmetic results.
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Affiliation(s)
- Corina Zamfir Snykers
- Hôpital Universitaire Des Enfants Reine Fabiola, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Elea De Plaen
- Hôpital Universitaire Des Enfants Reine Fabiola, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Sophie Vermersch
- Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne, France
| | - Manuel Lopez
- Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne, France
| | - Karim Khelif
- Hôpital Universitaire Des Enfants Reine Fabiola, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Stephane Luyckx
- Hôpital Universitaire Des Enfants Reine Fabiola, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Paul Philippe
- Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
| | - Francois Varlet
- Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne, France
| | - Henri Steyaert
- Hôpital Universitaire Des Enfants Reine Fabiola, Université Libre de Bruxelles (ULB), Brussels, Belgium
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Abstract
OBJECTIVE Direct excision of dermoid cysts of the eyebrow and forehead may lead to a prominent facial scar. Endoscopic techniques have greatly reduced the morbidity of excising benign orbitofacial masses. Access, visualization, and dissection of these masses are comparable to open approaches without the use of large or conspicuous incisions. This study evaluates the efficacy of the endoscopic approach in the treatment of dermoid cysts of the eyebrow and defines the place of this approach as an alternative to open surgery. MATERIALS AND METHODS Between July 2008 and April 2015, a total of 23 pediatric patients (13 females and 10 males) with dermoid cysts of the brow underwent excision by endoscopy. The mean age was 11.9 months (2-32 months). The lesion was located on the lateral brow in 17 cases and on the hairless forehead in 6 cases. To assess osseous involvement, sonography and magnetic resonance imaging study were performed in 22 and 1 case, respectively. Medical photos documentation was done systematically. For those children having an excision of cyst by endoscopy, the operative time, hystopathological examination, specimen size, and hospital stay were evaluated. In addition, parents of these patients were contacted to determine satisfaction with the procedure. RESULTS All procedures were successfully performed endoscopically. The mean operative time was 41 minutes (range 17-120 minutes). There was no intraoperative complication. The mean specimen size was 12 mm. In postoperative period, 1 patient presented edema on the forehead with uneventful course. All procedures were performed on the day-surgery. The hystopathological examinations were dermoid cysts in 21 cases, hemangioma in 1 case, and dermatofibroma in 1 case. The mean follow-up was 45.5 months (4-84 months). There was no residual mass or recurrence after long follow-up. Cosmetic results were excellent and all families were pleased with the outcome. CONCLUSIONS Endoscopic excision of forehead masses and dermoid cysts of the eyebrow is safe and it has proven to be an effective and minimally invasive alternative to the conventional approach. The main advantage of this procedure is the minimization of scar visibility compared with open surgery.
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Affiliation(s)
- Manuel Lopez
- Department of Pediatric Surgery and Urology, University Hospital of Saint Etienne , Saint Etienne, France
| | - Sophie Vermersch
- Department of Pediatric Surgery and Urology, University Hospital of Saint Etienne , Saint Etienne, France
| | - François Varlet
- Department of Pediatric Surgery and Urology, University Hospital of Saint Etienne , Saint Etienne, France
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Vigier C, Vigier JE, Vermersch S, Debeugny P, Krivosic-Horber R. [Prophylactic use of ornidazole in digestive surgery in neonates and children]. LARC Med 1982; 2:260-3. [PMID: 7169917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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